hadspread tothelymphnodesofher neck,andIwas
called in to decide whether to operate. This second,
unrelatedcancerwasinfactoperable.Butthyroidcancers
take years to become lethal. Her lung cancer would
almost certainly end her life long before her thyroid
cancer caused any trouble. Given the extent of the
surgerythatwouldhavebeenrequiredandthepotential
complications, the best course wasto do nothing. But
explainingmyreasoningtoSara meantconfrontingthe
mortality of her lung cancer, something that I felt ill
prepared to do.
Sittinginmyclinic,Saradidnotseemdiscouragedbythe
discoveryofthissecondcancer.Sheseemeddetermined.
She’dreadaboutthegoodoutcomesfromthyroidcancer
treatment.Soshewasgearedup,eagertodiscusswhento
operate. And I found myself swept along by her
optimism. Suppose Iwas wrong,I wondered, and she
provedtobethatmiraclepatientwhosurvivedmetastatic
lung cancer? How could I let her thyroid cancer go
untreated?
Mysolutionwastoavoidthesubjectaltogether.Itold
Sara that there was relatively good news about her
thyroidcancer—itwasslowgrowingand treatable.But
theprioritywasherlungcancer,Isaid.Let’snotholdup
the treatment for that. We could monitor the thyroid
cancer for now and plan surgery in a few months.
Isawhereverysixweeksandnotedherphysicaldecline
fromonevisittothenext.Yet,eveninawheelchair,Sara
would always arrive smiling, makeup on and bangs
bobby-pinnedoutofhereyes.She’dfindsmallthingsto
laugh about, like the strange protuberances the tubes